KRISTEN ALICE DERDERIAN (NPI# 1407417645) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407417645 |
| Entity Type | Individual |
| Full Name | KRISTEN ALICE DERDERIAN |
| Credential | CNP |
| Practice Address |
100 Industrial Park Rd Ste 1 Taunton MA 02780-7396 |
| Practice Telephone | 5088222266 |
| Mailing Telephone | 6176694745 |
| Enumeration Date | 2019-06-27 |
| Last Update Date | 2020-11-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
RN2321686 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 330 Tremont St, Braintree, MA 021845630 | 6176694745 |
| Street Address |
100 INDUSTRIAL PARK RD STE 1 |
| City | TAUNTON |
| State | MA |
| Zip Code | 02780-7396 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326564642 | Danielle Elise Cahn | Nurse Practitioner | 100 Industrial Park Rd Ste 1, Taunton, MA 02780-7396 | 2017-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235766338 | Peter A. Bertelli | Registered Nurse | Attn: Peter A. Bertelli, Rn, 70 Main Street, Taunton, MA 02780 | 2020-03-26 |
| 1790321388 | Daniel Bettencourt | Counselor | 1 Washington St. Taunton, Ma 02780, Taunton, MA 02780 | 2019-11-19 |
| 1629620067 | Lauren Mulkern | Behavior Technician | 36 Saints Way, Taunton, MA 02780 | 2019-07-16 |
| 1154891737 | Sara Keller | Physical Therapist | 68 Dean Street, Taunton, MA 02780 | 2018-11-27 |
| 1366931594 | Alicia Marie Donahue | Optometrist | 2005 Bay Street Suite 206, Taunton, MA 02780 | 2018-05-03 |
| 1922522879 | Kathryn Louise Drapeau | Registered Nurse | 17 Patriot Road, Taunton, MA 02780 | 2017-08-02 |
| 1174057913 | Marie Lorquet | Registered Nurse | 111 Bay St, Taunton, MA 02780 | 2017-04-19 |
| 1912351693 | Samantha Hollis | Social Worker | 126 Dighton Avenue, Taunton, MA 02780 | 2016-04-19 |
| 1689030843 | Alexandra Rhae Lynn | Counselor | 1 Washington St., Taunton, MA 02780 | 2016-01-04 |
| 1386058261 | Carmen Iris Rivera | Registered Nurse | 111 Worcester St, Taunton, MA 02780 | 2014-06-18 |
| Find all providers in zip 02780 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366092314 | Kristen Cummings | Nurse Practitioner | 233 Winthrop St, Taunton, MA 02780-4428 | 2019-09-11 |
| 1225052160 | Terri A. Sullivan | Nurse Practitioner | 2005 Bay St, Taunton, MA 02780-1085 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760082366 | Donna Josephine Remmes | Nurse Practitioner | 313 Franklin St, Wrentham, MA 02093-2405 | 2020-11-01 |
| 1912513714 | James Vincent Fournier | Nurse Practitioner | 50 Memorial Dr Ste 205, Leominster, MA 01453-2238 | 2020-09-17 |
| 1386259109 | Maureen Villars | Nurse Practitioner | 32 Orchard Hill Dr, Rutland, MA 01543-1778 | 2020-09-09 |
| 1639783780 | Patricia Varela | Nurse Practitioner | 48 Percival St, Dorchester, MA 02122-1992 | 2020-09-05 |
| 1578172243 | Felicia Mendonca | Nurse Practitioner | 21 Lands End Way, Swansea, MA 02777-2909 | 2020-07-28 |
| 1831716901 | Joan Tiano | Nurse Practitioner | 595 Pawtucket Blvd Ste 3, Lowell, MA 01854-2042 | 2020-07-06 |
| 1720609829 | Angelique Group | Nurse Practitioner | 4 Upland Woods Cir Unit 402, Norwood, MA 02062-3261 | 2020-04-29 |
| 1093341331 | Frew Fikru | Nurse Practitioner | 529 Washington Ave Apt 2, Revere, MA 02151-1962 | 2020-03-18 |
| 1376189084 | Dorcas Korir | Nurse Practitioner | 248 Pleasant St Unit 204, Methuen, MA 01844-7149 | 2019-11-18 |
| 1376194142 | Nicholas Davenport Biscardi | Nurse Practitioner | 6 Wells St, Gloucester, MA 01930-3423 | 2019-09-24 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.